What is it?

A dialysis catheter is a plastic tube that is placed in a large blood vessel. This catheter can be placed to provide temporary access to the bloodstream, for instance, while waiting for an arteriovenous fistula to become usable or as permanent access if an AV fistula cannot be placed.

The permanent dialysis catheter has a subcutaneous cuff (a thickened Dacron (felt) cuff) to promote ingrowth and prevent ascending infection. In the first weeks after placement, the permanent catheter is adhered to the skin with a suture. This means that the catheter cannot move and the cuff will have the opportunity to grow firmly into place.

The physician decides which dialysis catheter is the most suitable for you and provides the best results.

Placement of a dialysis catheter

The temporary dialysis catheter is placed under local anaesthetic by a nephrologist. This is usually done in a neck vein or in a vein under the collar bone; these are termed a ‘jugular’ or ‘subclavian’ venous catheter, respectively. Veins in the groin can be used for this too, in which case it is termed a ‘femoral’ venous catheter. A temporary dialysis catheter is usually placed in the Dialysis Department, whereas the placement of a permanent dialysis catheter may be done either in the Dialysis Department, the Radiology Department or in the Surgery Department. A permanent dialysis catheter can be placed under a local anaesthetic and sedation or under a light general anaesthetic by the nephrologist or the vascular surgeon.

The catheter bandage

When you are in the Dialysis Department for your dialysis treatment, the dialysis nurses and physicians will pay special attention to the dialysis catheter to prevent infections. Sterile dressings will be applied and only the dialysis nurses may handle them. This is done on a weekly basis or more frequently, as required. The dressing is applied in such a way that the catheter cannot move inward and at the same time, is protected against external impacts.
The catheter dressing consists of a part that covers the insertion site of the catheter and a part that wraps around the tip of the catheter. If no dialysis takes place, the clamps on the dialysis catheter must always remain closed and the caps must always remain in place. Only staff from the Dialysis Department may use your catheter to draw blood or to administer medication or fluids.

Checking the dressing

The dressing around the tip of the catheter is loosened for each dialysis so that the catheter can be connected to the bloodlines of the dialysis machine. The dressing at the insertion site of the catheter is usually replaced once a week by the dialysis nurses unless it causes irritation, has come loose or is soiled.
Check the dressing for dirt, pus or blood yourself too every day. A soiled dressing may indicate a beginning infection. It is important to notice this as early as possible and inform the dialysis nurses or the nephrologist.

Self-care of dialysis catheter

It is important that you carefully look after your dialysis catheter yourself, including when you are away from the Dialysis Department. In this way, you take care of your health directly yourself.

Make sure that you wear comfortable clothing on the day of your dialysis treatment. Clothing must have a wide neck or buttons. This will allow the nurses to handle your catheter better and replace the dressing more easily.

Ensure that the catheter bandage is adhered properly and always remains clean and dry. If you want to take a shower, the catheter must be covered with a plastic covering. If your catheter bandage is wet, it must be replaced as soon as possible. You need to come to the Dialysis Department to have this done. After a shower, your dialysis catheter must always be cared for during the next dialysis treatment.

Take care that the dialysis catheter is not pulled during your daily activities or while dressing and undressing. If you feel that your clothing catches on something: do not pull on it, as that may pull out the catheter. If you notice that the catheter is no longer covered by a catheter bandage or shows signs of infection, contact the Dialysis Centre. Possible signs of infection are fever, shivering, redness, feeling warm, pain and the presence of fluid or pus near the catheter.

Centres and specialist areas

Nephrology

Latest publication date: 05/02/2021
Supervising author: Dr De Vleeschouwer Mieke